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Summary of Results

Health Topic:   Central nervous system
Guidance:   Dementia
Description:   The summary of the published clinical guideline on Dementia. It links to the published guidance and key documents.

NICE implementation uptake reports

Implementation uptake report Assessment Published Date Coverage

External literature

External literature Assessment Coverage

National Audit Office (2007) Improving services and support for people with dementia

Description: A review of dementia services - findings include: 69% GPs had a local memory service; a service mapping exercise found 131 services (up from 58 in 2000); 26% CMHTs used MRI scans regularly and 66% used CT scans regularly to exclude other pathologies and establish type of dementia; people with dementia and carers found information and support through voluntary services only; 29% CMHTs offered cognitive stimulation regularly; 16% CMHTs provided palliative treatments regularly and 45% occasionally

Doubts about or mixed impact in practice National

Banerjee, S (2009) The use of antipsychotic medication for people with dementia: Time for action Department of Health publication

Description: Independent report commissioned by the Department of Health. Statistics obtained indicate that 180,000 people with dementia may be on antipsychotics at any time. Results indicate that treatment was unnecessary in nearly 150,000 cases. The report also estimated that of the 180,000 people given the drugs each year, only 36,000 benefited.

Not graded National

Perecherla, S et al (2010) Variations in anti-dementia drug prescribing Progress in Neurology and Psychiatry 13 (4) 30-33

Description: The study considered data from 21 participating specialist mental health trusts , of which 19 were interested in benchmarking their prescribing data. These trusts provided services for 54 PCTS. Results found that the median proportion of prescriptions for anti-dementia drugs originating from Mental Health Trusts was 25%, although variation was large. This may indicate that the model of shared care recommended by NICE is being implemented, albeit inconsistently.

Doubts about or mixed impact in practice National

Alzheimer's Society (2009) Counting the cost: Caring for people with dementia on hospital wards

Description: Quantative and qualitative evidence was collected via a questionaire from the following groups: Carers (1,291) , nursing staff (657) , nurse/ward managers (479). 77% of nurse managers and 77% of nursing staff said that antipsychotic drugs were always or sometimes used to treat people with dementia in the hospital environment. Many carers did not know what antipsychotic drugs are. Of those carers who did think the drugs were prescribed, 29% thought this was appropriate but 49% didn't.

Doubts about or mixed impact in practice National

Reddy J et al (2011) Assessment and support for carers of dementia patients at Sandwell Park Hospital, Hartlepool UK European Psychiatry 26, 2011

Description: A standardised questionnaire was answered by 25 carers attending the outpatient clinics, Memory clinics, Day Hospital and Inpatients at Sandwell Park Hospital. The questionnaire contained 8 questions reflecting NICE guidelines. Results found that 80% (20/25) of the carers were aware of all the available support.

Practice appears to be in line with guidance Local

Bangar S et al (2011) Clinical audit on NICE guidance on anti-cholinesterases in a memory clinic European Psychiatry Conference Publication (var.pagings). 26, 2011.

Description: Small study - The data for this study was collected from patients attending a memory clinic at Park Royal Centre for Mental Health in Central London . 16 patients were randomly selected for this audit. The baseline MMSE score in all 16 patients was above the recommended score 12. It was found that NICE guidance was followed in 75% of patients.

Practice appears to be in line with guidance Local

The NHS Information Centre for Health and Social Care (2011) Establishment of Memory services-Provisional results of a survey of Primary Care Trusts, 2011

Description: The report on NHS memory services covers financial spend from 1st April 2008 to 31st March 2011, and implementation of services over this time as well as future plans. Surveys were sent to 149 PCT's and Care Trusts. 118 responses (79%) were received. Results found that of respondents, 93% currently commission memory services, with a further 5% intending to implement these services in future. An estimated average of 3 memory services are commissioned by each organisation.

Practice appears to be in line with guidance National

Royal College of Psychiatrists Centre for Quality Improvement (2011) Report of the National Audit of Dementia Care in General Hospitals 2011

Description: This audit examines the quality of care received by dementia patients in general hospital. Data was collected between March 2010 and April 2011 on 89% of eligible hospitals. Results found that 34% of hospitals reported having adequate protocols in place for the treatment and management of patients with symptoms of dementia, 28% of dementia patients received antipsychotic medication in the hospital. 12% of dementia patients were newly prescribed this medication during this admission to hospital.

Doubts about or mixed impact in practice National

Wightman R et al (2011) Audit of antipsychotic prescribing in dementia: Cambridgeshire results and lessons learnt Psychiatria Danubia 2011; Vol. 23, Suppl. 1, pp 126-129. Conference paper.

Description: This small study explored antipsychotic prescribing in people with dementia. The notes of 67 patients in the Cambridegshire area were reviewed. Only 9 patients were being prescribed antipsychotics for behavioural and psychological symptoms in dementia (BPSD). There was good evidence in all cases that alternative diagnoses and management strategies had been explored before presrcibing an antipsychotic, however, in none was the full range of potential causes or interventions explored.

Practice appears to be in line with guidance Local

Royal College of Physicians (2012) Report of the 2011 inpatient falls pilot audit

Description: This pilot audit examined services for inpatients vulnerable to falls in acute and community hospitals and mental health units. Data was collated from 46 NHS trusts between 1 Nov and 13 Dec 2011. Despite ?pockets of excellent practice? the report found that falls assessments & interventions are not consistently provided for eligible patients - 23% had no review of  medication, 40% did not have their vision assessed, and 47% were not assessed for osteoporosis. 

Doubts about or mixed impact in practice National

House of Commons All-Party Parliamentary Group on Dementia (2012) Unlocking diagnosis - The key to improving the lives of people with dementia

Description: This inquiry by the All Party Parliamentary Group on Dementia aimed to improve the rates of diagnosis of dementia in the UK. Evidence considered included 1,075 completed questionnaires. A large number of responses stated that GPs should have greater training in dementia, while 40% of the 90 GPs who responded to the questionnaire themselves said that they had ?some but not enough? or ?none beyond the basic training in medical school? when asked about training in dementia diagnosis.

Doubts about or mixed impact in practice National

Health and Social Care Information Centre (2012) National Dementia & Antipsychotic Prescribing Audit 2012

Description: This audit collected demographic and prescribing information on people with dementia from primary care clinical systems between 2006 and 2011. Results show a decrease of 10.25% in the number of people with dementia receiving prescriptions for antipsychotic medication from 17.05% in 2006 to 6.8% in 2011. Results also found a 51.8% reduction in the number of people with dementia receiving a prescription for antipsychotic medication from 2008 to 2011.

Doubts about or mixed impact in practice National

Alzheimer's Society (2013) Mapping the Dementia Gap 2012. Progress on improving diagnosis of dementia 2011-2012

Description: This report presents dementia diagnosis rates in the United Kingdom for 2011-2012. The figures show the estimated number of people with dementia (diagnosed and undiagnosed) in 2012 was 792,862; while the number of people on QoF dementia registers (number with a diagnosis) was 364,329 (46%). This did however represent an increase in diagnosis rates from 2011 of 2.7%.

Doubts about or mixed impact in practice National

Royal College of Psychiatrists (2013) National audit of dementia

Description: This audit collected data between April and October 2012 from 210 participating hospitals via an organisational checklist and a retrospective case note audit. Results showed that 84% of hospitals prescription and administration of antipsychotic drugs were in line with NICE guidance. Results also found that 55% of hospitals had a policy or guideline in place to ensure patients with dementia were assessed for the presence of delirium at presentation.

Doubts about or mixed impact in practice National

Royal College of Psychiatrists (2013) English National Memory Clinics Audit Report

Description: Results are presented from an audit of memory clinics in England conducted between July and September 2013. 178 of 214 memory clinics in England responded, a response rate of 83%. The audit found that 66.3% of clinics have access to Cognitive Stimulation Therapy, a NICE recommended psychological intervention for dementia. Results also show that 93.8% of clinics provide education and support for carers of people with dementia.

Doubts about or mixed impact in practice National

This page was last updated: 01 November 2013

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Selected, reliable information for health and social care in one place

Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.